Introduction Sports physiotherapists regularly assess and treat shoulder pathologies. In my clinical practice, shoulders would place in the top 3 most common conditions (along with back and knee presentations). Given the frequency with which we see these problems, there is much interest in the best assessment and rehabilitation techniques for shoulder problems. This article will […]
Thoracic Outlet Syndrome: Assessment and Management
Introduction The condition discussed in this article, you will come to find, is quite complex and can be a battle for the physiotherapist and physical therapist. Thoracic outlet syndrome is considered to be a collection of quite diverse syndromes rather than a single entity (Yanaka et al., 2004), and therefore, accurate diagnosis and enlightened treatment […]
Identifying Subscapularis Tears: The Diagnostic Accuracy of Clinical Tests
Shoulder injuries to the rotator cuff are very common. Whilst rotator cuff injuries are more commonly seen in supraspinatus and infraspinatus, there has been a recent increase in awareness and recognition of subscapularis injuries. In fact, Barth et al. (2006) suggested 29.4% of those who underwent shoulder arthroscopy for a rotator cuff tear had involvement of the subscapularis. Therefore, a thorough understanding of the evidence based clinical assessment for subscapularis is essential, and is thus presented in this article.
Treatment of Scapular Dyskinesis
As I suggested in the previous post: assessment of scapular dyskinesis; sports physiotherapists regularly assess and rehabilitate shoulder dysfunctions and pathologies. As a sports physiotherapists it is important to evaluate the contributing factors to shoulder pathology. A common contributor, seen in 68-100% of shoulder injuries, is scapular dyskinesis. If you treat shoulders, ‘treating the scapula’ is absolutely paramount … ignore it at your own peril. This article will discuss some treatment options for scapular dyskinesis
Assessment of Scapular Dyskinesis
Sports physiotherapists regularly assess and rehabilitate shoulder dysfunctions and pathologies. As a sports physiotherapists it is important to evaluate the contributing factors to shoulder pathology. A common contributor, seen in 68-100% of shoulder injuries, is scapular dyskinesis. Accurate and comprehensive assessment of scapular dyskinesis is essential to identify alterations in normal scapulo-humeral rhythm. If you treat shoulders, ‘treating the scapula’ is absolutely paramount … ignore it at your own peril.
TSP005: The Throwing Shoulder with Rod Whiteley
In this episode of the podcast I interview Rod Whiteley. Dr Rod Whiteley (FACP) is a Specialist Sports Physiotherapist, and has extensive experience working with elite sportsand has consulted with the Australian Baseball Federation and the Australian Institute of Sport. He is widely published in peer review journals on the topic of the throwing shoulder.
Posterior Shoulder Instability: Evidence Based Diagnosis and Management
As sports physiotherapists we regularly assess and treat patients and athletes with shoulder instability. It has been suggested that glenohumeral instabllity affects up to 2% of the general population (Ahlgren et al., 1978). However, we know that posterior instability is much less common accounting for somewhere between 2 and 10% of these cases (Tannenbaum & Sekiya, 2011). The reason why it is important for use is that these presentations are most common in athletes, secondary to either overuse or a traumatic episode. This makes knowledge of evidence based management and diagnosis of posterior shoulder instability particularly pertinent.
Identifying Acromioclavicular Joint Pain: The Diagnostic Accuracy of Clinical Tests
Acromioclavicular injuries are common in a variety of sports, particularly those which involve heavy contact or tackling. For example, Flik et al (2005) reported the incidence of AC injuries was the third most common in men’s ice hockey. Thus, this is a common injury. Whilst in many injury cases, such as acute presentations and the higher grade AC separations, the diagnosis can be quite obvious. However, many conditions of the shoulder present with very similar clinical presentations, and thus differential diagnosis can be challenging (Meyer et al 1990). Thus, this article examines the diagnostic accuracy for clinical examination tests for acromioclavicular joint pain.
Rotator Cuff Activity During Shoulder Adduction Exercises
When I say optimal shoulder function what do you think? My guess for many of you it is likely ‘rotator cuff function’ (yeah, for some it may be scapulohumeral rhythm). However, you would undoubtedly agree that optimal function of the rotator cuff musculature is essential in the successful rehabilitation of the majority of shoulder pathologies. It is common in clinical practice to utilise shoulder adduction movements to guide clinical decision making, particular in subacromial impingement syndrome patients. However, a recent EMG study has challenged the validity of both these assessment and treatment decisions.
Subacromial Impingement Syndrome: Posterior Capsule Tightness and the “Diablo Effect”
The sports physiotherapist will commonly treat shoulder presentations. One of the most common presentations, particularly in an athletic population, is subacromial impingement syndrome (or external impingement). Therefore, it is essential that the sports physiotherapist be fully aware of the more common contributing factors and treatments for this condition. This article discusses the effect of posterior capsule tightness and the “Diablo Effect” on subacromial impingement syndrome.